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INTRODUCTION Opioid-related mortality appears to be increasing in Canada. We examined the true extent of the problem and the impact of the introduction of long-acting oxycodone. METHODS We examined trends in the prescribing of opioid analgesics in the province of Ontario from 1991 to 2007. We reviewed all deaths related to opioid use between 1991 and(More)
IMPORTANCE Three clinical decision rules were previously derived to identify patients with headache requiring investigations to rule out subarachnoid hemorrhage. OBJECTIVE To assess the accuracy, reliability, acceptability, and potential refinement (ie, to improve sensitivity or specificity) of these rules in a new cohort of patients with headache. (More)
STUDY OBJECTIVE To compare outcomes after acute acetaminophen poisoning in 2 large cohorts of patients treated with either the 20-hour intravenous or 72-hour oral acetylcysteine protocol. METHODS We conducted a retrospective cohort study with historical control comparing patients treated with one of 2 acetylcysteine regimens. Data for the 20-hour group(More)
CASE REPORT We report a case of methanol poisoning exhibiting complete recovery from severe visual impairment following treatment with ethanol, fomepizole, and hemodialysis. An adult male presented with central blindness after ingesting methanol. Initial visual acuity was <20/800 (finger counting at 1-2 feet) with retinal edema on fundoscopy, arterial pH(More)
STUDY OBJECTIVE The elimination kinetics of ethylene glycol (EG) in human subjects treated with fomepizole (4-methylpyrazole) were analyzed to establish the efficacy of alcohol dehydrogenase (ADH) inhibition and to characterize elimination pathways. METHODS Drug concentration data from patients enrolled in the EG arm of the Methylpyrazole for Toxic(More)
OBJECTIVE To validate a previously derived decision rule for the use of radiography in patients with acute knee injury. DESIGN Prospectively administered survey. SETTING Emergency departments of two university hospitals serving adults. PATIENTS Convenience sample of 1096 of 1251 eligible adults with acute knee injuries; 124 patients were examined by(More)
CONTEXT The Ottawa Knee Rule is a previously validated clinical decision rule that was developed to allow physicians to be more selective and efficient in their use of plain radiography for patients with acute knee injuries. OBJECTIVE To assess the impact on clinical practice of implementing the Ottawa Knee Rule. DESIGN Controlled clinical trial with(More)
OBJECTIVES To ascertain whether the sedative agent administered during neuromuscular-blocking agent-facilitated intubation (rapid sequence intubation [RSI]) influences the number of attempts and overall success at RSI. METHODS Records were drawn from an ongoing, prospective multicenter registry of emergency department intubations. Conditional logistic(More)
OBJECTIVE To identify high risk clinical characteristics for subarachnoid haemorrhage in neurologically intact patients with headache. DESIGN Multicentre prospective cohort study over five years. SETTING Six university affiliated tertiary care teaching hospitals in Canada. Data collected from November 2000 until November 2005. PARTICIPANTS(More)
OBJECTIVE To measure the sensitivity of modern third generation computed tomography in emergency patients being evaluated for possible subarachnoid haemorrhage, especially when carried out within six hours of headache onset. DESIGN Prospective cohort study. SETTING 11 tertiary care emergency departments across Canada, 2000-9. PARTICIPANTS(More)